Nurses working in emergency departments ED of trauma centers participate as members of the trauma team in the initial resuscitation of severely injured patients. Decisions regarding these resuscitations are made in high stress environments and are inevitably rife with ethical issues due to the high frequency of injury and its exorbitant costs to society. These decisions are made with little background knowledge about the patients during a complex process of rapid assessment of physiological status overlaid by ethical principles, societal norms and expectations, and legal mandates. Research shows that nurses are confronted with various ethical issues throughout many nursing specialties, leading to consequences such as job dissatisfaction and moral distress which can decrease quality of care. However, the specific ethical issues ED nurses experience during the resuscitation of severely injured patients, the factors contributing to the ethical decisions made during the these situations, and how nurses are involved in these decisions remain largely unknown. The purpose of this study is to explicate ED nurses' perceptions of ethical issues and decisions during resuscitation of severely injured patients. A qualitative descriptive design using semi- structured face-to-face interviews of ED nurses participating in the initial resuscitation of severely injured patients will be used to answer the following four research questions: 1.) What ethical issues arise during the initial resuscitation of severely injured patients?, 2.) How are ED nurses affected by the ethical issues that arise during initial resuscitation of severely injured patients?, 3.) What factors contribute to the ethical decisions made during the initial resuscitation of severely injured patients?, and 4.) How are nurses involved in making decisions during resuscitation of severely injured patients? This study will initiate a trajectory of empirical bioethics research examining the ethics involved in trauma and the effects they have on health care providers. This will ultimately lead to methods of improving health care provider ethical decision making in regards to trauma patients and situations thereby improving the care trauma patients receive. The negative effects of ethical issues can lead to decreased quality of care and poor patient outcomes. With the high occurrence of injury, decreased quality of care and poor patient outcomes can have devastating effects on public health. Addressing the ethical issues encountered by the ED nurses can lead to strategies and interventions to assist in coping with these issues and decisions. This will not only improve public health, but also address NINR's mission statement and strategic goals improving the nursing work environment, quality of care, and possibly retention of nurses. [unreadable] [unreadable] [unreadable]